Paramedic acute stroke treatment assessment (PASTA)

Conditions

Topic: Stroke

Christopher Price, Phil White, Joyce S. Balami, Nawaraj Bhattarai, Diarmuid Coughlan et al. (15 authors)

Programme Grants for Applied Research2022-05-016 citations

Cost-effectiveness of an enhanced Paramedic Acute Stroke Treatment Assessment (PASTA) during emergency stroke care: Economic results from a pragmatic cluster randomized trial

Nawaraj Bhattarai, Christopher Price, Peter McMeekin, Mehdi Javanbakht, Luke Vale et al. (7 authors)

International Journal of Stroke2021-03-164 citations

10.1177/17474930211006302

Effect of an Enhanced Paramedic Acute Stroke Treatment Assessment on Thrombolysis Delivery During Emergency Stroke Care

Christopher Price, Lisa Shaw, Saiful Islam, Mehdi Javanbakht, Alan Watkins et al. (18 authors)

JAMA Neurology2020-04-1332 citations

10.1001/jamaneurol.2020.0611

Paramedic Acute Stroke Treatment Assessment (PASTA): study protocol for a randomised controlled trial.

Price CI, Shaw L, Dodd P, Exley C, Flynn D, Francis R, Islam S, Javanbakht M, Lakey R, Lally J, McClelland G, McMeekin P, Rodgers H, Snooks H, Sutcliffe L, Tyrell P, Vale L, Watkins A, Ford GA.

2019-02-1211 citations

10.1186/s13063-018-3144-z

Interventions

Participants will randomly receive either the Paramedic Acute Stroke Treatment Assessment (PASTA) pathway or usual emergency stroke care, according to the paramedic that attends their emergency call.

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: Paramedics allocated to delivering the PASTA pathway will be asked to deliver this to the following patients: 1. Aged 18 years and over. 2. Face Arm Speech Test (FAST) positive or any presentation of new focal neurological symptoms which indicate acute stroke in the paramedic's clinical judgement. 3. Within 4 hours of last known to be without new stroke symptoms in the paramedic’s judgement. 4. Admission to a study hospital Patients will be identified and approached about enrolment in the study after arrival at hospital. Patients approached about enrolment will meet the following criteria: 1. Travelled to hospital with a study paramedic 2. Aged 18 years and over 3. Hospital specialist diagnosis of stroke 4. Within 4 hours of stroke onset (onset time determined by the hospital stroke team) when assessed by the study paramedic

Exclusion criteria

Exclusion criteria: Not meeting the inclusion criteria

Design outcomes

Primary

Measure	Time frame
Current primary outcome measure as of 18/12/2019: Treatment with intravenous thrombolysis on the day of hospital admission assessed by examining medical records Previous primary outcome measure: Dependency measured using the modified Rankin Scale (mRS) at 90 days after stroke.	—

Secondary

Measure	Time frame
Current secondary outcome measures as of 18/12/2019: 1. Stroke severity measured by the National Institute of Health Stroke Scale in the medical records at 24 h after thrombolysis 2. Medical complications at 24 h after thrombolysis by examining medical records 3. Dependency assessed using the modified Rankin Scale at discharge from hospital and 90 days after stroke 4. Discharge destination at discharge from hospital assessed by examining medical records 5. Assistance with activities of daily living required at discharge from hospital assessed by examining medical records and at 90 days after stroke by participant interview 6. Residence at 90 days after stroke assessed by examining medical records and participant interview Previous secondary outcome measures: 1. Stroke severity measured by the National Institute of Health Stroke Scale at 24 hours after thrombolysis 2. Medical complications at 24 hours after thrombolysis 3. Dependency (mRS), discharge destination and assistance with activities of daily living required, at discharge from hospital 4. Residence and assistance with activities of daily living required at 90 days after stroke	—

Measure

Time frame

Current secondary outcome measures as of 18/12/2019: 1. Stroke severity measured by the National Institute of Health Stroke Scale in the medical records at 24 h after thrombolysis 2. Medical complications at 24 h after thrombolysis by examining medical records 3. Dependency assessed using the modified Rankin Scale at discharge from hospital and 90 days after stroke 4. Discharge destination at discharge from hospital assessed by examining medical records 5. Assistance with activities of daily living required at discharge from hospital assessed by examining medical records and at 90 days after stroke by participant interview 6. Residence at 90 days after stroke assessed by examining medical records and participant interview Previous secondary outcome measures: 1. Stroke severity measured by the National Institute of Health Stroke Scale at 24 hours after thrombolysis 2. Medical complications at 24 hours after thrombolysis 3. Dependency (mRS), discharge destination and assistance with activities of daily living required, at discharge from hospital 4. Residence and assistance with activities of daily living required at 90 days after stroke

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Countries

England, United Kingdom

Outcome results

None listed